A recent analysis of churn rates among children found that while churn rates increased among children of all racial and ethnic groups, the increase was largest for Hispanic children, suggesting they face greater barriers to maintaining coverage. Estimates indicate that among full-benefit beneficiaries enrolled at any point in 2018, 10.3% had a gap in coverage of less than a year (Figure 3). But because Democrats are squeamish about this, theyre going to use it to drive a hard bargain. As a result, individuals who were enrolled in HUSKY Health may have their benefits extended . But thats no longer relevant in terms of the resumption of Medicaid eligibility redeterminations. HHS has laid out some basic guidelines, and states have four general options in terms of how they handle the unwinding of the continuous coverage protocols and the return to regular eligibility redeterminations for the entire Medicaid population: If youre still eligible for Medicaid under your states rules, youll be able to keep your coverage. If the answer is yes, be sure you pay close attention to any requests for additional information from your states Medicaid office, as they may need that in order to keep your coverage in force. That is now expected to happen in May 2023. For people whose income has increased enough to make them ineligible for Medicaid, but still eligible for this special enrollment period, there will be more flexibility in terms of access to coverage. These reporting requirements were part of a broad set of CMS guidance documents issued over the past several months. Medicaid enrollment increased by over 17 million from February 2020 to May 2022. Thats because Medicaid and CHIP eligibility for children extend to significantly higher income ranges, and marketplace subsidies are never available if a person is eligible for Medicaid or CHIP. ts noteworthy that the additional federal Medicaid funding that states have received is. The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 However, the Administrations superseding debt forgiveness program is still pending in the courts. %PDF-1.6
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This increase is in large part due to the extension of the COVID-19 pandemic public health emergency (PHE).2 Due to the maintenance of effort requirements under the Families First Coronavirus Response Act (FFCRA), which has precluded most forms of involuntary disenrollment from The impending termination of FFCRAs continuous coverage rules and return to business as usual for Medicaid can be a nerve-wracking prospect for some enrollees. And if youve moved or your contact information has changed since you first enrolled in Medicaid, make sure the state has your current contact information on file. Many states have continued to send out these renewal notifications and information requests throughout the pandemic (nearly all states have been conducting automatic (ex parte) renewals when possible, and more than half the states have also been sending renewal forms to enrollees). Fortunately, Medicaid was able to step in and provide health coverage when people lost their income. In 2020, one in ten Medicaid enrollees moved in-state and while shares of Medicaid enrollees moving within a state has trended downward in recent years, those trends could have changed in 2021 and 2022. Medicaid enrollment has increased since the start of the pandemic, primarily due to the continuous enrollment provision. HHS Secretary Xavier Becerra announced the decision Wednesday via a declaration. Under the Consolidation Appropriations Act, 2023, the resumption of Medicaid disenrollments is no longer linked to the end of the COVID public health emergency. States that accept the enhanced federal funding can resume disenrollments beginning in April but must meet certain reporting and other requirements during the unwinding process. Can you appeal your states decision to disenroll you? The Biden administration on Friday extended the Covid-19 public health emergency for another three months. These waivers include strategies allowing states to: renew enrollee coverage based on SNAP and/or TANF eligibility; allow for ex parte renewals of individuals with zero income verified within the past 12 months; allow for renewals of individuals whose assets cannot be verified through the asset verification system (AVS); partner with managed care organizations (MCOs), enrollment brokers, or use the National Change of Address (NCOA) database or US postal service (USPS) returned mail to update enrollee contact information; extend automatic enrollment in MCO plans up to 120 days; and extend the timeframe for fair hearing requests. Doing so would decrease federal spending on Medicaid and allow states to remove ineligible people from the program, saving the government tens of billions of dollars. hb```k- There will also be continued access to pathways for emergency use authorizations (EUAs) for COVID-19 products (tests, vaccines, and treatments) through the Food and Drug Administration (FDA), and major telehealth flexibilities will continue to exist for those participating in Medicare or Medicaid. The COVID public health emergency (PHE) is expected to be extended again in January 2023, but the omnibus bill de-links the resumption of Medicaid eligibility redeterminations from the PHE, and allows states to start processing eligibility determinations as of April 1, 2023. Twenty-eight states indicated they had settled on plan for prioritizing renewals while 41 said they planning to take 12 months to complete all renewals (the remaining 10 states said they planned to take less than 12 months to complete renewals or they had not yet decided on a timeframe). And all states accepted the additional federal Medicaid funding. How states approach the unwinding process will have implications for the ability of eligible individuals to retain coverage and those who are no longer eligible to transition to other coverage. This policy update will examine several of the health-related COVID-19 Federal Emergency Declarations and which flexibilities will end in May. Written by Diane Archer. Question Is there an association between prenatal care coverage in emergency Medicaid (a program of restricted Medicaid services for recent immigrants with low income who are pregnant) and the use of antidiabetic agents by pregnant Latina individuals with gestational diabetes?. This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made, and summarizes the flexibilities triggered by each in the following. However, there will also be current enrollees who are determined to be no longer be eligible for Medicaid, but who may be eligible for ACA marketplace or other coverage. The new rules give states a clear time frame: They can begin to initiate the renewal/redetermination process as early as February 1, 2023 (states can start this in February, March, or April), and disenrollments can be effective as early as April 1, 2023 if adequate notice is given to the enrollee. Enrollees who have moved may not receive important renewal and other notices, especially if they have not updated their contact information with the state Medicaid agency. Importantly, these findings also show that large shares of enrollees (41% in the KFF analysis) reenroll in Medicaid after a period of time, and many after a period of uninsurance. By halting disenrollment during the PHE, the continuous enrollment provision has also halted this churning among Medicaid enrollees. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. Browse plans and costs with an easy, anonymous online tool. 506 0 obj
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This is something both Democratic and Republican states asked for so that the 90 million people enrolled in Medicaid can be given certainty and protected during this massive undertaking.. Preparing for the End of COVID-19: Return to Regular Renewals . The question is: Can they get enough wins to take the political sting off allowing states to kick people off the rolls?. Many people who enrolled in Medicaid since early 2020 have never experienced the regular eligibility redeterminations and renewal processes that have long been a part of Medicaid, and those will resume in April 2023 (some enrollees wont receive a renewal notification for several months after that, depending on the approach that their state uses). Some people who will lose Medicaid eligibility are now eligible for Medicare instead. However, waivers that allowed advanced practice registered nurses (APRNs) to practice at the top of their license will expire on October 9 absent further Congressional action. Nearly every state has been conducting some type of outreach campaign around this, asking Medicaid enrollees to be sure that the state has their current contact information on file. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. The Consolidated Appropriations Act, 2023 (enacted in December 2022) has given states a specific date April 1, 2023 when they can begin terminating coverage for enrollees who are no longer eligible. The law also prohibits states from disenrolling a person simply based on undelivered mail. If BBB had been enacted in December, states would have had three months to get ready. Efforts to conduct outreach, education and provide enrollment assistance can help ensure that those who remain eligible for Medicaid are able to retain coverage and those who are no longer eligible can transition to other sources of coverage. Tate Reeves, after months of resistance, asks lawmakers to pass postpartum Medicaid extension by Bobby Harrison February 26, 2023 February 26, 2023. Total Medicaid/CHIP enrollment grew to 91.3 million in October 2022, an increase of 20.2 million or more than 28.5% from enrollment in February 2020 (Figure 1). In the third quarter, it will drop to 2.5 percentage points, and in the fourth quarter of 2023, states will receive 1.5 percentage points in additional federal Medicaid funding. Plus, if you funnel people into subsidized Obamacare plans, those are more expensive than Medicaid.. In the Calendar Year (CY) 2022 Home Health Prospective Payment System (PPS) final rule, CMS snuck . So, there is some ambiguity as to when payments will be required to resume. Under normal circumstances, they would have lost their Medicaid eligibility upon turning 65, as the, that allows for a six-month special enrollment period during which a Medicare-eligible person who loses Medicaid coverage can transition to Medicare without a late enrollment penalty. Importantly, the legislation requires these reports be made publicly available. As part of the Consolidated Appropriations Act, 2023, signed into law on December 29, 2022, Congress set an end of March 31, 2023 for the continuous enrollment provision, and phases down the enhanced federal Medicaid matching funds through December 2023. While the PHE ends on May 11, in payments rules CMS has extended the waivers for an additional 152 days to allow providers time to undo the waivers. including education, public health, justice, environment, equity, and, . 541 0 obj
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Helping millions of Americans since 1994. For enrollment reporting, states will provide baseline data at the start of the unwinding period related to applications, enrollment, estimated timeframe for completing initiated renewals, and fair hearings, and then states will submit monthly reports that will be used to monitor these metrics throughout the unwinding period (Figure 10). The lower estimate accounts for factors, such as new people enrolling in the program as well as people disenrolling then re-enrolling in the program within the year, while the higher estimate reflects total disenrollment and does not account for churn or new enrollees. the extra cost that states have incurred to cover the FFCRA-related enrollment growth. States can also consider sharing information on consumers losing Medicaid who may be eligible for Marketplace coverage with Marketplace assister programs; however, in a recent survey, few assister programs (29%) expected states to provide this information although nearly half were unsure of their states plans. On January 30, the Biden Administration announced May 11, 2023, as the targeted end date for the national public health emergency (PHE) declarations implemented during the COVID-19 pandemic. What do these three possible scenarios mean for Medicaid if Congress does not take additional action as proposed in the Build Back Better Act (BBB)? That same analysis revealed that a majority of states provide general information about reasonable modifications and teletypewriter (TTY) numbers on or within one click of their homepage or online application landing page (Figure 8), but fewer states provide information on how to access applications in large print or Braille or how to access American Sign Language interpreters. Meghana Ammula However, if the guardrails are too flimsy or non-existent, states could see a surge in their uninsured populations right as government Covid funding runs dry, and individuals will have to depend on health plans to cover tests, vaccines and therapeutics for the virus. By law, public health emergencies are declared in 90-day increments. V,wfBt3 [ho
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Dig Deeper Medicaid Spending on. You can unsubscribe anytime you want. A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1994. Theres always a risk of scams and abuses should that happen, Rollins cautioned, arguing that the calling and texting ban should only be lifted for the period of the Medicaid redeterminations.
The GOP-led Senate passed the proposal in the 2022 session, but it was killed in the House. What if your income has increased to a level thats no longer Medicaid-eligible? The temporary loss of Medicaid coverage in which enrollees disenroll and then re-enroll within a short period of time, often referred to as churn, occurs for a several reasons. %PDF-1.7
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The COVID SEP ended in most states. People using this window can, If youre eligible for Medicare, youll have. Outcomes will differ across states as they make different choices and face challenges balancing workforce capacity, fiscal pressures, and the volume of work. The powers activated by the emergency. Additionally, the federal government had offered an additional 6.2% match for states who met maintenance of effort criteria during the PHE. If you no longer meet your states Medicaid eligibility guidelines, its a good idea to understand what your options will be when your state begins disenrolling people who are no longer eligible. A proposed rule, released on September 7, 2022, seeks to streamline enrollment and renewal processes in the future by applying the same rules for MAGI and non-MAGI populations, including limiting renewals to once per year, prohibiting in-person interviews and requiring the use of prepopulated renewal forms.
As states prepare to complete redeterminations for all Medicaid enrollees once the continuous enrollment provision ends, many may face significant operational challenges related to staffing shortages and outdated systems. Check out this important update From Centers for Medicare & Medicaid Services "Update: On Thursday, December 29, 2022, President Biden signed into law H.R. Ensuring accessibility of information, forms, and assistance will be key for preventing coverage losses and gaps among these individuals. However, when states resume Medicaid disenrollments when the continuous enrollment provision ends, these coverage gains could be reversed. When the continuous enrollment provision ends and states resume redeterminations and disenrollments, certain individuals will be at increased risk of losing Medicaid coverage or experiencing a gap in coverage due to barriers completing the renewal process, even if they remain eligible for coverage. Under the prior rules, that would have meant that Medicaid eligibility redeterminations (and terminations) could have resumed as of June 2023. 0
Lastly, states are required to maintain up to date contact information and attempt to contact enrollees prior to disenrollment when mail is returned. Under normal circumstances, they would have lost their Medicaid eligibility upon turning 65, as the Medicaid eligibility rules are much different (and include asset tests) for people 65 and older. March 31, 2023 is the last day that states have to maintain the continuous coverage rules that have been in place since March 2020. Total Medicaid/CHIP enrollment grew to 90.9 million in September 2022 . The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE).